Assessment of Serum Uric Acid Levels Among Gestational Diabetes Patients in Erbil City.

BACKGROUND AND OBJECTIVES

Gestational diabetes mellitus (GDM) is a common obstetrical disorder with a significant impact on maternal and fetal well-being. This study aimed to assess serum uric acid levels in pregnant women with GDM and determine their diagnostic performance.

METHODS

A case-control study was conducted at Erbil Maternity Hospital and primary health care units from May to December 2024, involving 200 pregnant women (100 with GDM and 100 healthy controls). Sociodemographic, obstetric, dietary, and laboratory data were collected. Serum uric acid was measured using the uricase method, and its association with GDM was evaluated using receiver operating characteristic (ROC) curve analysis and multivariable logistic regression.

RESULTS

Serum uric acid demonstrated excellent discriminative ability for GDM (area under the curve (AUC) = 0.940). The optimal cut-off value of 3.15 mg/dL yielded 90% sensitivity and 80% specificity. Women with uric acid ≥ 3.15 mg/dL had 122.8-fold higher odds of GDM (odds ratio (OR) = 122.8, 95% confidence interval (CI): 34.4-437.8, p < 0.001) after adjusting for age, body mass index (BMI), and gestational age; each 1 mg/dL increase was associated with a 30.7-fold increase in odds (OR = 30.7, 95% CI: 10.9-86.3, p < 0.001). Elevated uric acid was present in 90% of women with GDM compared to 11% of controls. This prevalence is higher than that reported in Egypt (54.7%) and India (74.7%). Higher BMI, grand multiparity, positive family history of diabetes, and reduced plant-based food intake were also significantly associated with GDM.

CONCLUSION

Elevated serum uric acid is strongly associated with GDM, with a cut-off of 3.15 mg/dL providing high diagnostic accuracy. The prevalence observed was higher than in several international studies. Limitations include the facility-based design, lack of adjustment for diet and renal function in the analysis, and potential recall bias.